Edema
Describe paste bandages
The unna boot is a paste bandage. You would use if for an edema leg ulcer. It is impregnated gauze (zinc oxide, gelatin and glycerin). It hardens as it dries as to not allow swelling. It should be changed every 4-7 days.
Describe in your own words what venous edema is like.
There is pitting, the skin is very thin. There is a loss of texture/tone and creases in the tissue. Swelling occurs in the distal extremities.
Describe the characteristics of edema when it is non-pitting.
Tissue is firm blockage present fluid cannot move because there is a lot of pressure
What happens when there is trauma that causes the localized edema?
Trauma-> increase in capillary permeability -> edema
What are different ways we can assess edema? (5)
girth/volumetric measurements ROM MMT Neurologic assessment ie reflex/sensation Skin assessment. color/temp/pitting or non
What causes edema?
Obstruction or blockage in the venous or lymphatic system, the affected tissue obtains abnormally large amount of fluid in the intracellular space
Describe generalized edema.
Occurs with chronic illness ie cardiac failure, kidney disease, liver disease.
______ _____ stagnates in the tissue in lymphedema.
Plasma proteins
How long should you apply cold for edema?
< 12' for vasoconstriction.
How is it classified?
Appearance (brawny, pitting, non-pitting) , type (lymphedema, venous) , location (localized/generalized)
Define Edema
Build up of fluid in the interstitial space, it can be extracellular or intracellular.
How would you elevate them?
Elevate LE at least 18 cm above heart. Do this intermittently throughout the day for 20-30 minutes up to 2 hours per day.
How do you treat edema? (6)
Elevation Paste bandages Pressure garments Cold US ES
Describe the characteristics of brawny edema.
Fibrotic changes in connective tissue discoloration of skin Tissue is swollen, hard and inelastic
Describe in your own words the characteristics of Lymphedema.
It can be pitting or non-pitting, The tissue can be soft or hard. It is tender along the lymph channels and it can pocket below the elbows or knees.
Describe the ways that systemic/generalized edema may present in the body.
It can be swelling of the groin and bilateral lower extremities or all over "total body edema"
How does US help edema?
It increases cell membrane permeability and this allows the interstitial fluid to be re-absorbed.
In your own words, describe systemic edema.
It is pitting, there is swelling in the groin and LE, or it can present as weight gain.
How does ES help edema?
It stimulates the muscle pump which creates a mm contraction.
What type of edema is limited to 1 area of the body? Can it be bilateral?
Localized edema, it can be bilateral ie ankle sprain.
When there is a problem with _____ return like a ____ ____ or an _____ valve, what happens to the blood?
Venous/blood clot/incompetent. Pools in the lower extremities.
what is Lymphedema?
When there is a damage/obstruction in the lymphatic system (normally lymphatic ducts) and plasma proteins stagnate in the tissue.
Describe venous edema
When there is a problem with venous return like a blood clot or incompetent valve, pooling of blood occurs in the LE.
Traumatic edema is due to ____ . It is ____, ____, and ____ . Generally it is ___-_____ . It is found ____ and ____ to the site of injury.
inflammation. warm, red, tender. non-pitting. proximal and distal.
Describe the scale for pitting edema
mild 1+ 0-1/4" moderate 2+ 1/4-1/2" severe 3+ 1/2-1" very severe 4+ >1"
The unna boot is a type of ___ ____ . You would use this for an ___ ___ ___ . It is impregnated gauze with 3 things. It ____ as it dries to not allow ____ . How often should it be changed?
paste bandage. Edematous leg ulcer. Zinc oxide, glycerin and gelatin. Hardens, swelling. Every 4-7 days.
Lymphedema can be ____ or ___-____ . The tissue can be ___ or ___ . It is ___ along the lymph channels. It can ____ below the ___ and ___ .
pitting or non-pitting. Soft or hard. Tender. pocket/elbow and knee
Systemic edema is ____ , swelling occurs around the ____ and ____ or it can present as ____ ____ .
pitting, groin/lower extremities, weight gain.
With venous edema ____ is present, the skin is ____, swelling of the ___ ____ . There is a loss of ___ , ___ , ___ .
pitting, thin, distal extremities, tone/creases/texture
TEDS and Jobst are types of ___ ____ . They help to prevent ___ ___ .
pressure garments. Blood Clots.
With pitting edema the tissue is ___ and a small ___ is left after you remove your finger, it gradually disappears.
soft/depression
What can cause localized edema?
trauma or infection